Psychiatric Toxicities of Cancer Therapies

2021 ◽  
pp. 374-382
Author(s):  
Daniel C. McFarland ◽  
Mehak Sharma ◽  
Yesne Alici
Keyword(s):  
Targeted Therapies ◽  
Cancer Therapies ◽  
Paradigm Shifts ◽  
Prognostic Information ◽  
Cancer Treatments ◽  
Patient Reported ◽  
Targeted Drug ◽  
New Treatments ◽  
Targeted Drug Therapies ◽  
Collection And Management

The psychiatric effects of cancer treatments should receive renewed interest based on cancer treatment–related paradigm shifts and the ever-changing parade of new and improving cancer treatments. Precision medicine in oncology relies on personal molecular analysis and is touching patients in profound ways by providing prognostic information to guide treatment decisions. Due to enhancements in molecular sciences as well as data collection and management, the development of new treatments has accelerated in the field of oncology in particular. While there are many advantages to increasing the speed of drug development, ensuring that the psychiatric and psychological outcomes of these treatments are well understood remains a largely undeveloped area. This chapter introduces immunotherapies and targeted drug therapies, their mechanisms of action, and what is known about their psychiatric toxicity profiles. The chapter focuses on outlining the scientific rationale behind newer treatments such as immunotherapy and targeted therapies so that psychiatric consequences, perhaps yet to be discovered, may be further understood. Increased attention to patient-reported outcomes will hopefully enhance the identification of psychiatric consequences of immunotherapy and targeted therapies in oncology.

Genetic and Epigenetic Modulation of Drug Resistance in Cancer: Challenges and Opportunities

2020 ◽  
Vol 20 (14) ◽  
pp. 1114-1131 ◽  
Author(s):  
Kanisha Shah ◽  
Rakesh M. Rawal
Keyword(s):  
Drug Resistance ◽  
Drug Targets ◽  
Complex Disease ◽  
Cancer Therapies ◽  
Altered Expression ◽  
Acquired Drug Resistance ◽  
Challenges And Opportunities ◽  
Chemotherapeutic Treatment ◽  
Epigenetic Modulation ◽  
Targeted Drug Therapies

Cancer is a complex disease that has the ability to develop resistance to traditional therapies. The current chemotherapeutic treatment has become increasingly sophisticated, yet it is not 100% effective against disseminated tumours. Anticancer drugs resistance is an intricate process that ascends from modifications in the drug targets suggesting the need for better targeted therapies in the therapeutic arsenal. Advances in the modern techniques such as DNA microarray, proteomics along with the development of newer targeted drug therapies might provide better strategies to overcome drug resistance. This drug resistance in tumours can be attributed to an individual’s genetic differences, especially in tumoral somatic cells but acquired drug resistance is due to different mechanisms, such as cell death inhibition (apoptosis suppression) altered expression of drug transporters, alteration in drug metabolism epigenetic and drug targets, enhancing DNA repair and gene amplification. This review also focusses on the epigenetic modifications and microRNAs, which induce drug resistance and contributes to the formation of tumour progenitor cells that are not destroyed by conventional cancer therapies. Lastly, this review highlights different means to prevent the formation of drug resistant tumours and provides future directions for better treatment of these resistant tumours.

Lipid-based Nanoplatforms in Cancer Therapy: Recent Advances and Applications

2020 ◽  
Vol 20 (4) ◽  
pp. 271-287 ◽  
Author(s):  
Kuldeep Rajpoot
Keyword(s):  
Drug Delivery ◽  
Cancer Therapy ◽  
Adverse Effects ◽  
Targeted Drug Delivery ◽  
Tumor Therapy ◽  
Cancer Therapies ◽  
Medication Delivery ◽  
Lipid Nanocarriers ◽  
Targeted Drug ◽  
Drug Nanocarriers

Though modern available cancer therapies are effective, they possess major adverse effects, causing non-compliance to patients. Furthermore, the majority of the polymeric-based medication platforms are certainly not universally acceptable, due to their several restrictions. With this juxtaposition, lipid-based medication delivery systems have appeared as promising drug nanocarriers to replace the majority of the polymer-based products because they are in a position to reverse polymer as well as, drug-associated restrictions. Furthermore, the amalgamation of the basic principle of nanotechnology in designing lipid nanocarriers, which are the latest form of lipid carriers, has tremendous chemotherapeutic possibilities as tumor-targeted drug-delivery pertaining to tumor therapy. Apart from this, it is reported that nearly 40% of the modern medication entities are lipophilic. Moreover, research continues to be efficient in attaining a significant understanding of the absorption and bioavailability of the developed lipids systems.

scholarly journals Asciminib Mitigates DNA Damage Stress Signaling Induced by Cyclophosphamide in the Ovary

2021 ◽  
Vol 22 (3) ◽  
pp. 1395
Author(s):  
Luca Mattiello ◽  
Giulia Pucci ◽  
Francesco Marchetti ◽  
Marc Diederich ◽  
Stefania Gonfloni
Keyword(s):  
Ovarian Reserve ◽  
Kinase Inhibitor ◽  
Concomitant Administration ◽  
Cancer Therapies ◽  
Cancer Treatments ◽  
Abl Tyrosine Kinase ◽  
Negative Impacts ◽  
Abl Tyrosine Kinase Inhibitor

Cancer treatments can often adversely affect the quality of life of young women. One of the most relevant negative impacts is the loss of fertility. Cyclophosphamide is one of the most detrimental chemotherapeutic drugs for the ovary. Cyclophosphamide may induce the destruction of dormant follicles while promoting follicle activation and growth. Herein, we demonstrate the in vivo protective effect of the allosteric Bcr-Abl tyrosine kinase inhibitor Asciminib on signaling pathways activated by cyclophosphamide in mouse ovaries. We also provide evidence that Asciminib does not interfere with the cytotoxic effect of cyclophosphamide in Michigan Cancer Foundation (MCF)7 breast cancer cells. Our data indicate that concomitant administration of Asciminib mitigates the cyclophosphamide-induced ovarian reserve loss without affecting the anticancer potential of cyclophosphamide. Taken together, these observations are relevant for the development of effective ferto-protective adjuvants to preserve the ovarian reserve from the damaging effects of cancer therapies.

scholarly journals Practical Application of Patient-Reported Health Status Measures for Transcatheter Valve Therapies

2021 ◽  
Author(s):  
Vittal Hejjaji ◽  
David J. Cohen ◽  
John D. Carroll ◽  
Zhuokai Li ◽  
Pratik Manandhar ◽  
...  
Keyword(s):  
Health Status ◽  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Summary Score ◽  
Hazard Ratio ◽  
Valve Repair ◽  
Prognostic Information ◽  
Risk Of Death ◽  
Transcatheter Mitral Valve Repair ◽  
Patient Reported

Background: Health status assessment is essential for documenting the benefit of transcatheter aortic valve replacement (TAVR) or transcatheter mitral valve repair on patients’ symptoms, function, and quality of life. Health status can also be a powerful marker for subsequent clinical outcomes, but its prognostic importance around the time of both TAVR and transcatheter mitral valve repair has not been fully defined. Methods: Among 73 699 patients who underwent transfemoral TAVR or transcatheter mitral valve repair between 2011 and 2018 (mean age, 81.9±7.0 years, 53% men, 92% TAVR), we constructed sequential models examining the association of health status (as assessed with the Kansas City Cardiomyopathy Questionnaire–Overall Summary Score; KCCQ-OS) at baseline, 30 days, change from baseline to 30 days, and combinations of these assessments with death and heart failure (HF) hospitalization from 30 days to 1 year. Results: Although higher baseline KCCQ-OS and 30-day KCCQ-OS scores were each associated with lower risk of death and HF hospitalization (in individual models and in a model including both measures), the 30-day KCCQ-OS was most predictive (death: hazard ratio, 0.89 per 5-point increase [95% CI, 0.89–0.90]; HF hospitalization: hazard ratio, 0.91 [95% CI, 0.90–0.91]). The 30-day KCCQ-OS also was most predictive when included in a separate model with change in KCCQ from baseline to 30 days. Similar findings were noted for the outcomes of death and of HF hospitalization, unadjusted and adjusted for patient factors. All interaction terms between procedure type and KCCQ were not significant, suggesting that health status provided similar prognostic information in both procedures. Conclusions: The patient’s assessment of their health status immediately before and 30 days after TAVR and transcatheter mitral valve repair is associated with subsequent risk of death and HF hospitalization, with the 30-day assessment being most strongly associated with outcomes. Our findings support the routine use of KCCQ data as a prognostic tool.

scholarly journals Patient-reported outcomes in ovarian cancer

2017 ◽  
Vol 5 (2) ◽  
pp. 51-54
Author(s):  
Ilaria Sabatucci ◽  
Francesco Perrone
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Patient Reported Outcomes ◽  
Cancer Treatments ◽  
Treatment Benefit ◽  
Functional Quality ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related

Ovarian cancer treatments may negatively impact the physical and functional quality of life domains of patients. Patient-reported outcomes (PROs) and health-related quality of life (HR-QoL) assess the health conditions of patients without interpretation by a clinician of the patient’s response. A broad spectrum of validated questionnaires investigating HR-QoL exist. However, none are considered as a gold standard of PRO measures. In clinical trials, PROs are a means of evaluating treatment benefit or risk in a way that complements the typical primary outcome of survival, and are necessary endpoints to support regulatory approval. In clinical practice, PROs are useful in monitoring the ability of patients to tolerate treatment and in identifying patients more at risk for subsequent health problems who would benefit from supportive care during and after treatment.

Current Therapies and Future Prospects

2021 ◽  
pp. 306-318
Author(s):  
Muddukrishnaiah K.
Keyword(s):  
Drug Delivery ◽  
Drug Resistance ◽  
Cancer Therapy ◽  
Cancer Diagnosis ◽  
Biomarker Discovery ◽  
Future Prospects ◽  
Cancer Treatments ◽  
Therapeutic Uses ◽  
Current Therapies ◽  
Targeted Drug

Due to drug resistance, lack of cancer cell selectivity, and solubility, conventional cancer treatments lose their therapeutic uses, and as such, new therapeutic agents need to be developed. Nanomaterials and peptides are increasingly being used in the fields of cancer diagnosis, biomarker discovery due to their therapeutic values and novel way of targeting and curing the disease. Synergism among the peptide-conjugated nanoparticles is an exhilarating group of materials, not only sharing the benefits of conventional nanomedicine, but also possessing the unique properties of excellent biocompatibility, biodegradability, versatile sensitivity, specific biological purpose, and synthetic feasibility. These virtues inspired by the scientists and have taken advantage in the peptide-conjugated nano drugs for the accurate delivery of drugs reliably to the site of the lesion. This chapter offers a summary of emerging technologies that have recently been developed in the broad field of peptide-conjugated nanoparticles and offers guidance for targeted drug delivery and cancer therapy.

Orthopaedic surgery in the palliation of cancer

2021 ◽  
pp. 839-848
Author(s):  
Mohamed Yakoub ◽  
John Healey
Keyword(s):  
Bone Disease ◽  
Chronic Condition ◽  
Orthopaedic Surgery ◽  
Functional Limitation ◽  
Metastatic Bone Disease ◽  
Site Specific ◽  
Pain Disability ◽  
Targeted Drug ◽  
Surgical Treatments ◽  
Targeted Drug Therapies

Metastatic spread of cancer to bone is frequent and causes pain, disability, and functional limitation. Non-surgical treatments such as chemotherapy and hormone therapy are effective in early disease. Administration of bisphosphonates or osteoprotegerin inhibitors prevent new ‘bone events’, thereby avoiding pain, radiation, and surgery. Radiotherapy arrests disease and relieves pain in many cases. Surgery is needed when the bone is weak or fractured. It effectively relieves pain and preserves function by bypassing the deficient bone with site-specific reconstructive surgery. Surgery should be selected based on projections of patient survival. New tools to make these projections are now available (https://www.pathfx.org/). New targeted drug therapies appear to be changing metastatic bone disease into a more chronic condition. This will alter the management of local disease in many histological subtypes of metastatic cancers.

scholarly journals microRNA: The Impact on Cancer Stemness and Therapeutic Resistance

Cells ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 8 ◽  
Author(s):  
Xueqiao Jiao ◽  
Xianling Qian ◽  
Longyuan Wu ◽  
Bo Li ◽  
Yi Wang ◽  
...  
Keyword(s):  
Stem Cells ◽  
Noncoding Rna ◽  
Tumor Recurrence ◽  
Tumor Promoter ◽  
Therapeutic Resistance ◽  
Cancer Therapies ◽  
Cancer Treatments ◽  
Small Noncoding Rna ◽  
Anti Cancer ◽  
The Impact

Cancer ranks as the second leading cause of death worldwide, causing a large social and economic burden. However, most anti-cancer treatments face the problems of tumor recurrence and metastasis. Therefore, finding an effective cure for cancer needs to be solved urgently. Recently, the discovery of cancer stem cells (CSCs) provides a new orientation for cancer research and therapy. CSCs share main characteristics with stem cells and are able to generate an entire tumor. Besides, CSCs usually escape from current anti-cancer therapies, which is partly responsible for tumor recurrence and poor prognosis. microRNAs (miRNAs) belong to small noncoding RNA and regulate gene post-transcriptional expression. The dysregulation of miRNAs leads to plenty of diseases, including cancer. The aberrant miRNA expression in CSCs enhances stemness maintenance. In this review, we summarize the role of miRNAs on CSCs in the eight most common cancers, hoping to bridge the research of miRNAs and CSCs with clinical applications. We found that miRNAs can act as tumor promoter or suppressor. The dysregulation of miRNAs enhances cell stemness and contributes to tumor metastasis and therapeutic resistance via the formation of feedback loops and constitutive activation of carcinogenic signaling pathways. More importantly, some miRNAs may be potential targets for diagnosis, prognosis, and cancer treatments.

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